I deal with this every day, in fact it's my profession. I'm the charge RN on the Cardiac Progressive 3 (step down) floor at the local hospital. Basically that means that I see the Open heart surgeons every morning and take care of their patients every night. Here's how it goes down here. As mentioned above, the actual surgery is fairly routine these days, it's the recovery period that can vary from facility to facility, depending on where he is, who does the surgery, and what type of surgery he has. There are 2 basic kinds of CABG (coronary artery bypass grafting), and they are the traditional "open heart" where the surgeon operates by cutting through the sternum, and there is a newer minimally invasive robotic surgery performed at some hospitals with a davinci robot. This surgery does have less scarring, but in my experience it is possible to have greater complications. At our hospital the patient will go to the CVICU immediately after surgery and is still intubated and on many cardiac drips. The patient will also have A and V wires which are attached directly to the heart in case a temporary pacemaker is needed, and two chest tubes coming out of the front of the chest, near the bottom of the sternum. At our hospital, most patients are also placed on an insulin drip for the first 3 days after surgery, even if they are not diabetic, because our endocrinologist and surgeons have decided that it helps with the healing process for the patient's blood glucose to be in good control. The day after your surgery the patient usually comes off the ventilator and some of the drips, and pending any further complications leaves the CVICU and comes to our floor, CP3. The first day the patient usually just rests in bed because they have already had a lot going on, being that they came off the vent and are waking up more and realizing what happened and how much is still attached to them. The second day post op, the foley catheter will come out, the IV in the neck (central line) will come out, as long as a peripheral IV is able to be placed, the A and V wires will probably come out depending on the heart rate and rhythm and any complications, and the chest tubes may or may not come out, depending on output and what that day's chest xray shows. The patient will be transferred out of the bed to a cardiac recliner chair for all 3 meals throughout the day. This is the first part of their cardiac rehab. Throughout the next 5-7 days, the patient will be educated with their post op activity orders, discharge orders, food orders, smoking cessation, and all new lifestyle. If there are little to no complications they will then be discharged to home. If they are not progressing as we'd like, but don't necessarily need a cardiac bed, we may transfer them to the in-house rehab floor for a week or so, to get the physical therapy they need.
My father had CABGx5 in 2007 (not at my hospital) and is doing great. He used to eat poorly, never exercise, chew 2 cans of copenhagen per day, and never go to the doctor. After his surgery he elected to to the outpatient cardiac rehab 4 days a week for a year and still exercises. He no longer chews, but smokes cigars (not nearly equal to what he chewed), and he exercises and has regular visits with his MD. To this day he's doing great.
Hope this helps!
